This article came from Psychology Today. In the five years of my depression (I’m now on the other side of the black box of depression), I found many physical manifestations of what I thought was an emotional disorder. I still find that when the black cloud of depression creeps too close to me, I notice pains in my chest and lower back. That’s a signal for me to use the tools in my toolchest to return to stability…and the pains go away.

Depression is a disorder of the body as much as of the mind. Consider

that several of the core symptoms of the condition manifest in body systems: depression invariably expresses itself in a change of appetite, usually inhibiting the desire to eat, but occasionally reversing course, as in atypical depression, and increasing it.

Similarly, the body’s need for restorative sleep is profoundly disturbed, and nearly all depressed individuals experience sleep problems; 80% complain of insomnia, another 15% sleep excessively. Insomnia by itself appears to be a risk factor for depression. Most patients complain of body fatigue. In many, energy loss is so overwhelming that physical movement is arduous and grinds to a paralyzing halt.

But of all the signs that depression has a neck-down presence, none is more insistent than physical pain. For a substantial number of people, possibly up to half of depression sufferers, bodily pain is the way depression presents itself.

The pain is often vague and unexplained by injury. It may show up as headache, abdominal pain, or musculoskeletal pains in the lower back, joints and neck—alone or in any combination. The painful physical symptoms of depression typically take the form of multiple somatic complaints.

The trouble is, too often neither sufferer nor doctor is aware of the true source of the problem and the depression goes untreated as well as unrecognized. It’s not that the pain is “all in the head.” No, the pain is indeed real, but it likely drives many people to primary care physicians or orthopedists in the mistaken belief that something has gone awry in their body. And there follows an unproductive search for an organic source.

In a study of over 25,000 patients at 15 primary care centers on five continents, Seattle researchers found that 50% of all depressed patients worldwide report multiple unexplained physical symptoms. It’s wasn’t that such patients were any less willing or able to express emotional distress. They readily acknowledged depressed mood when specifically asked about it.

Like the emotional symptoms, the painful physical symptoms of depression arise in specific nerve pathways presided over by the neurotransmitters serotonin and norepinephrine. From their base in the brainstem, such pathways travel up into the highest reaches of the brain, the frontal cortex, where they help regulate thinking and mood. They also travel up to the brain’s hypothalamus, where they regulate eating, sleeping, and sex drive.

But serotonin and norepinephrine pathways also travel down into the spinal cord serving the rest of the body. And therein lies the problem.

As the body goes about its tasks, there are constant sensations associated with the routine functioning of the body, such as digestion in the stomach and abdomen. The central nervous system is also fed routine inputs from the musculoskeletal system throughout the body. But normally those sensations are suppressed from consciousness and ignored. That’s what allows you to pay attention to the world outside your body.

And that suppression is normally accomplished by serotonin- and norepineprhine-dependent nerve fibers descending from the brain into the spinal cord. But they become dysfunctional in depression and fail to operate efficiently. As a result, routine sensory input “escapes” up into the brain, where it is interpreted as uncomfortable or even painful physical symptoms when in fact nothing is wrong.

Remember that the pathways of healing for one depressed is a three legged stool – body, soul, and spirit. I hadn’t had an article strictly on the body for quite a number of blogs and thought it was about time.

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About Patrick Day

In 2010, I escaped from four long years of deep, dark depression. This blog shares lessons I learned from those years as depicted in my autobiography - How I Escaped from Depression - as well as other insights about depression and anxiety that only come from someone who has gone through it. When you have a heart attack, you become an expert in heart attacks. When you have diabetes, you become an expert in that condition. As such, I am an expert in depression, with a four-year experiential degree and graduate studies in how to live a life going forward that keeps the ever-lurking Depression at a healthy distance.

7 Responses to 82. How Depression Affects the Body

Your comments here are exactly true and exactly why I have become a coach to those who are depressed. I know from experience that when you are depressed you don’t know what changes to make; you are in a fog. That’s when you need someone to stand alongside you and help you chart a course of recovery to stability. I had a counselor to help me, and my brother, a Christian psychotherapist, was my spiritual coach. I also had two good friends who were helping me. You’re right, I lost my confidence and needed help, and by the grace of God, I received it.

By the way, with changes anyone needs to make, I was not referring to working half time or not, though it sounds like that was a good choice for you. I was talking about changes in body activity, changes in thinking, changes in the spiritual life. I have a client I have been coaching for more than a year. When we first started, his situation was helpless and he saw no way out. I stood alongside him as a coach and a friend and he is now free of depression. It was the most remarkable turn-around I’ve ever seen. Did his work circumstances change? If anything, they became worse. No, his thinking, will, and emotions (the soul) changed, and his spiritual life changed.

I have written a book called TOO LATE IN THE AFTERNOON: One Man’s Triumph Over Depression in which Dave Logan stands alongside his friend Mitch Jasper as Mitch goes through the throes of depression – and comes out on the other side. I pray you have someone who can stand alongside you.

Loads better now, thanks. Had some great counselling and have been taking anti-depressants. Depression was my body saying ‘something has got to change in your life’ and I’ve made a big change by going part time (after a stressful fight with work), so onwards and upwards!

Great. I’m glad to hear it. Making changes in your life is so important to triumphing over depression. There are those who are depressed who don’t want to make any changes but don’t want to have depression any longer. To do the same things and expect different results is the definition of insanity.

I guess when you’re depressed though, if you don’t know what changes to make, then it can be very difficult to move forward. Plus, when you are depressed you tend to lose your confidence and this might be part of the reason for the apparent inertia. Also, if it is a life changing decision, then it is possibly best left till you feel well enough to know that it is the right thing to do.
In my case, HR is going to do a review with me after 6 months. I know that I won’t ask to go full time again because I already wanted to do that before I became depressed but in a different situation my decision might have been something I regretted once I got well again.